How can we get my mother-in-law evaluated for dementia?

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My mil saw her doctor, we told him about our concerns driving, not bathing, her balance and eye sight. He said she is good for 89 years old. He recommended visiting nurse come to her home but she can't drive in order to have them. We want to know if they will evaluate her for dementia or what we can do since her doctor does not want to deal with it.

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If she can't pass a driver test, then she would not be allowed to continue driving. Can't they bring her in for that type of evaluation? (You said she has poor vision.)

The other tests to determine cognitive decline are great ideas too. It's just that with the neurologist, MRI, neuropsychological evaluation, etc. it could take months to get results.

A geriatric primary should be able to gain info from the family about how she's not able to function and do a mini eval in the office. That's what my LO's primary did and determined significant dementia. I was fortunate that my LO had already handed me the keys and told me to sell her car. She was afraid to drive after forgetting how to open the door to get out once.

Is she demanding to continue to drive?
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You seem to be between a rock and a hard place here; is the doctor saying that he can't order the visiting nurse evaluation because she's not homebound, ie, still driving but shouldn't be?

Yes, you need to get her a full cognitive workup, best done by a team of neurologist and neuropsychologist. This includes several hours of paper and pencil testing which tests REASONING, not just memory. Until recently, my mother, with significant vascular dementia for several years, passed the "mini-mental" exam with flying colors--meaning she could remember words, draw a clock and knew who she was, where she was and who was president.

He doctor sounds like a real do-nothing type who doesn't want to have a hard conversation. Her vitals are fine so she's okay. What does it matter if she's blind, has slow reaction times and can't reason her way out of a paper bag! She's healthy! (in his eyes).

Unfortunately, you are probably waiting for an "event". A fall or accident that lands her in the hospital and then rehab. And once she's there, you talk to the social worker about the fact that she CAN'T go home and live alone any longer.

Alternatively, call VNS yourself and find out exactly what they need from the doctor in order to an "in home" assessment. Tell them that she thinks she can drive but shouldn't be and that you're trying to get the ball rolling to get her some in-home services. They may tell you what the doctor needs to write in order to properly write a script for this service.
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Have her doctor refer her to a geriatric doc, either neurologist, psychiatrist of general health geriatrician. Many geriatrician now do home visits. Have doc write an order for cognitive evaluation to be done by visiting nurse.
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Well, at least you are off to a start. See what happens with this nurse visit.
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She would not go along with seeing another doctor.
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yes she has to be considered homebound.No her doctor is not geriatric.
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Do you mean she has to be considered "home bound" to have home health services?
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Did he order a health assessment by Visiting Nurse Services? That would be a good place to start. Why do you think that mom would have to drive? They should come to her home!

It sounds as though her doctor isn't well versed in elders.

Is there a geriatrician you could get mom to? A geriatric psychiatrist is also a great suggestion.
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Ask for a referral to a neurologist or geriatric psych
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